PTSD, Depression, and Substance Abuse Symptoms in Women Exposed to Intimate Partner Abuse

The present study explores relationships among several established correlates of trauma in women exposed to intimate partner abuse (IPA), including PTSD, depression, and dissociation symptoms as well as alcohol use as well as other trauma-related variables, such as social support and violence exposure. Two analysis methods were utilized: variable-oriented methods, which examine relationships between variables, and person-oriented analysis methods, which examine groupings of participants within a larger sample (N = 233). Results of the variable-oriented analyses indicated positive links among depression, PTSD, dissociation, and alcohol use in women exposed to IPA, as well as positive links between the aforementioned psychological symptoms and exposure to violence. Social support was related to decreased psychological symptoms. Person-oriented analyses indicated the presence of four unique profiles of women within the larger study sample: Profile 1 (n = 21), which was labeled High Dissociation, Low Depression/PTSD; Profile 2 (n = 150), which was labeled Low Symptoms, High Social Support, Profile 3 (n = 41); which was labeled Low Dissociation, High Depression/PTSD; and Profile 4 (n = 22), which was labeled High Symptoms, Low Social Support. This research supports previous findings about the relationships among several variables related to IPA as well as suggests the need for careful consideration of differences among women within the larger context of research, advocacy, and clinical interventions related to IPA.

Recovery from Pediatric Brain Injury: A Preliminary Comparison of Longitudinal Data on Psychological Symptomology and Mental Health Treatment

Objective: To document the course of psychological symptomology, mental health treatment, and unmet psychological needs using caregiver reports in the first 18 months following pediatric brain injury (BI). Method: Participants included 28 children (aged 1-18 years) who were hospitalized at a children's hospital's rehabilitation unit. Caregiver reports of children's psychological symptoms, receipt of mental health treatment, and unmet psychological needs were assessed at one month, six months, 12 months, and 18 months post-BI. Results: Caregivers reported a general increase in psychological symptoms and receipt of mental health treatment over the 18 months following BI; however, there was a substantial gap between the high rate of reported symptoms and low rate of reported treatment. Across all four follow-up time points there were substantial unmet psychological needs (at least 60% of sample). Conclusions: Findings suggest that there are substantial unmet psychological needs among children during the first 18 months after BI. Barriers to mental health treatment for this population need to be addressed.

Psychological and Social Perspectives on Malingering and Symptom Exaggeration: Conceptualization and Interventions Using Acceptance and Commitment Therapy

Malingering and the production of false symptoms seen in such disorders as Factitious Disorder are an ongoing mystery to medical and mental health professionals. Historically, these presentations have been difficult to identify and treat. As might be expected, individuals with such symptomology rarely agree to participate in research, possibly because of a reluctance to admit to the feigning or exaggerating behaviors and a fear of reprisals. Many different etiologies have been proposed, including the assumption of roles in order to manage impressions, taking control of symptoms in order to gain attention or other rewards or avoid aversive events, and even the production of symptoms that is largely out of awareness such as is seen in conversion or somatoform presentations. By examining historical and present-day beliefs about etiology and treatment interventions, professionals can explore what new types of effective treatment might look like. The behaviorist philosophy that underlies Acceptance and Commitment Therapy proposes a perspective emphasizing effective working in context. This philosophy also suggests individuals sometimes engage in behavior in order to escape from or avoid aversive experiences. Utilizing case examples and fresh behavioral perspectives provides insight and ideas for conceptualization of these behaviors of interest. Using the above conceptualizations, an ACT based treatment of those who produce false symptoms is introduced.

Weight-Based Emotional Abuse: Self Psychological Implications for Treatment

The aim of this paper is to provide evidence that overweight individuals are at increased risk for emotional abuse compared to their normal weight counterparts. Studies examining weight-based discrimination and bullying demonstrate examples of emotional abuse aimed at overweight individuals. The psychological difficulties associated with emotional abuse, such as symptoms of anxiety, depression and social difficulties, are reviewed. It is hypothesized that similar psychological difficulties are experienced when obese persons experience weight based emotional abuse. A self psychological conceptualization is applied to understand the effect emotional abuse has on one's sense of self. A treatment proposal, which aims to utilize self-object transferences to strengthen the self, is offered. Future research for the application of self psychology in a group therapy format is discussed.